Basic Information
| Provider Information | |||||||||
| NPI: | 1881853778 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NIKAM | ||||||||
| FirstName: | NAVIN | ||||||||
| MiddleName: | SRINIVAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9330 MEDICAL PLAZA DR | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294069104 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8438473225 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 E QUINCY ST STE 410 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782152034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102237500 | ||||||||
| FaxNumber: | 2102239075 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 33403 | SC | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0011X | N4622 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology |
No ID Information.